Inner-city African-American women in the United States are at a disproportionate risk for HIV infection; thus, numerous HIV risk reduction interventions, based on social-cognitive theory, have been designed to effect HIV risk behavior change in this population. Unfortunately, these interventions have been only moderately successful in reducing HIV risk behavior. One reason why these interventions are of limited effectiveness is that HIV risk appears to be associated with many other issues. Data shows that people engage in HIV sexual risk for a myriad of reasons and their interactions are poorly understood. The proposed research will examine the interaction of childhood sexual abuse CSA, substance use, and HIV sexual risk. The intent of the research is to: 1) increase our understanding of how CSA and substance use contribute to the occurrence of HIV sexual risk behaviors; 2) develop a preliminary model for the interaction of psychosocial, behavioral, and experiential factors on HIV sexual behavioral risk; 3) develop a behavior change intervention aimed at reducing substance use and HIV behavioral risk in this population; and 4) perform a preliminary evaluation of this intervention in a target population of women seeking substance use disorder treatment who are at risk for HIV infection and who have past histories of CSA. Results from this study are likely to identify key factors that link HIV sexual risk and substance use and will be relevant for future studies of HIV prevention interventions among substance-using populations at-risk for HIV infection, abuse/dependence, and CSA.